|
SHVG SKN LESION 1 T/A/L DIAM 1.1-2.0 CM
|
Facility
|
OP
|
$197.00
|
|
|
Service Code
|
CPT 11302
|
| Hospital Charge Code |
6111302
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$53.78 |
| Max. Negotiated Rate |
$377.34 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$88.86
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$118.20
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$88.86
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$70.39
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$188.67
|
| Rate for Payer: Cash Price |
$118.20
|
| Rate for Payer: Cash Price |
$118.20
|
| Rate for Payer: Cigna Commercial |
$167.45
|
| Rate for Payer: First Health Commercial |
$177.30
|
| Rate for Payer: First Health Workers Compensation |
$76.06
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$177.30
|
| Rate for Payer: GEHA Commercial |
$157.60
|
| Rate for Payer: GEHA Medicare |
$188.67
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$177.30
|
| Rate for Payer: Humana ChoiceCare |
$207.54
|
| Rate for Payer: Humana Medicare Advantage |
$188.67
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$316.97
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$71.83
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$188.67
|
| Rate for Payer: Multiplan All |
$179.27
|
| Rate for Payer: New Mexico Health Connections Medicare |
$320.74
|
| Rate for Payer: OMNI Networks Commercial |
$137.90
|
| Rate for Payer: One Health Plan PPO/POS |
$177.30
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$82.94
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$71.83
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$188.67
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$187.15
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$377.34
|
| Rate for Payer: Three Rivers Provider Network All |
$147.75
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$184.90
|
| Rate for Payer: United Healthcare Managed Medicaid |
$71.83
|
| Rate for Payer: United Healthcare Medicare Advantage |
$188.67
|
| Rate for Payer: United Payors & United Providers UP&UP |
$183.21
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$188.67
|
| Rate for Payer: Zelis Auto |
$78.80
|
| Rate for Payer: Zelis Medicare |
$160.37
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$226.40
|
| Rate for Payer: Zelis Worker's Compensation |
$53.78
|
|
|
SHVG SKN LESION 1 T/A/L DIAM 1.1-2.0 CM
|
Facility
|
IP
|
$197.00
|
|
|
Service Code
|
CPT 11302
|
| Hospital Charge Code |
6111302
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$53.78 |
| Max. Negotiated Rate |
$187.15 |
| Rate for Payer: Cash Price |
$118.20
|
| Rate for Payer: Cigna Commercial |
$167.45
|
| Rate for Payer: First Health Commercial |
$177.30
|
| Rate for Payer: First Health Workers Compensation |
$76.06
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$177.30
|
| Rate for Payer: GEHA Commercial |
$137.90
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$177.30
|
| Rate for Payer: Multiplan All |
$179.27
|
| Rate for Payer: OMNI Networks Commercial |
$137.90
|
| Rate for Payer: One Health Plan PPO/POS |
$177.30
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$187.15
|
| Rate for Payer: Three Rivers Provider Network All |
$147.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$183.21
|
| Rate for Payer: Zelis Auto |
$78.80
|
| Rate for Payer: Zelis Worker's Compensation |
$53.78
|
|
|
SHVG SKN LESION 1 T/A/L DIAM 1.1-2.0 CM
|
Facility
|
IP
|
$371.07
|
|
|
Service Code
|
CPT 11302
|
| Hospital Charge Code |
7211302
|
|
Hospital Revenue Code
|
517
|
| Min. Negotiated Rate |
$101.30 |
| Max. Negotiated Rate |
$352.52 |
| Rate for Payer: Cash Price |
$222.64
|
| Rate for Payer: Cigna Commercial |
$315.41
|
| Rate for Payer: First Health Commercial |
$333.96
|
| Rate for Payer: First Health Workers Compensation |
$143.27
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$333.96
|
| Rate for Payer: GEHA Commercial |
$259.75
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$333.96
|
| Rate for Payer: Multiplan All |
$337.67
|
| Rate for Payer: OMNI Networks Commercial |
$259.75
|
| Rate for Payer: One Health Plan PPO/POS |
$333.96
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$352.52
|
| Rate for Payer: Three Rivers Provider Network All |
$278.30
|
| Rate for Payer: United Payors & United Providers UP&UP |
$345.10
|
| Rate for Payer: Zelis Auto |
$148.43
|
| Rate for Payer: Zelis Worker's Compensation |
$101.30
|
|
|
SHVING SKIN LES 1 S/N/H/F/G DIAM 0.5CM/<
|
Facility
|
IP
|
$302.00
|
|
|
Service Code
|
CPT 11305
|
| Hospital Charge Code |
20300135
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$82.45 |
| Max. Negotiated Rate |
$286.90 |
| Rate for Payer: Cash Price |
$181.20
|
| Rate for Payer: Cigna Commercial |
$256.70
|
| Rate for Payer: First Health Commercial |
$271.80
|
| Rate for Payer: First Health Workers Compensation |
$116.60
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$271.80
|
| Rate for Payer: GEHA Commercial |
$211.40
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$271.80
|
| Rate for Payer: Multiplan All |
$274.82
|
| Rate for Payer: OMNI Networks Commercial |
$211.40
|
| Rate for Payer: One Health Plan PPO/POS |
$271.80
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$286.90
|
| Rate for Payer: Three Rivers Provider Network All |
$226.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$280.86
|
| Rate for Payer: Zelis Auto |
$120.80
|
| Rate for Payer: Zelis Worker's Compensation |
$82.45
|
|
|
SHVING SKIN LES 1 S/N/H/F/G DIAM 0.5CM/<
|
Facility
|
IP
|
$302.00
|
|
|
Service Code
|
CPT 11305
|
| Hospital Charge Code |
8300009
|
|
Hospital Revenue Code
|
519
|
| Min. Negotiated Rate |
$82.45 |
| Max. Negotiated Rate |
$286.90 |
| Rate for Payer: Cash Price |
$181.20
|
| Rate for Payer: Cigna Commercial |
$256.70
|
| Rate for Payer: First Health Commercial |
$271.80
|
| Rate for Payer: First Health Workers Compensation |
$116.60
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$271.80
|
| Rate for Payer: GEHA Commercial |
$211.40
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$271.80
|
| Rate for Payer: Multiplan All |
$274.82
|
| Rate for Payer: OMNI Networks Commercial |
$211.40
|
| Rate for Payer: One Health Plan PPO/POS |
$271.80
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$286.90
|
| Rate for Payer: Three Rivers Provider Network All |
$226.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$280.86
|
| Rate for Payer: Zelis Auto |
$120.80
|
| Rate for Payer: Zelis Worker's Compensation |
$82.45
|
|
|
SHVING SKIN LES 1 S/N/H/F/G DIAM 0.5CM/<
|
Facility
|
OP
|
$281.82
|
|
|
Service Code
|
CPT 11305
|
| Hospital Charge Code |
7211305
|
|
Hospital Revenue Code
|
517
|
| Min. Negotiated Rate |
$76.94 |
| Max. Negotiated Rate |
$377.34 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$147.69
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$169.09
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$147.69
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$117.00
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$188.67
|
| Rate for Payer: Cash Price |
$169.09
|
| Rate for Payer: Cash Price |
$169.09
|
| Rate for Payer: Cigna Commercial |
$239.55
|
| Rate for Payer: First Health Commercial |
$253.64
|
| Rate for Payer: First Health Workers Compensation |
$108.81
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$253.64
|
| Rate for Payer: GEHA Commercial |
$225.46
|
| Rate for Payer: GEHA Medicare |
$188.67
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$253.64
|
| Rate for Payer: Humana ChoiceCare |
$207.54
|
| Rate for Payer: Humana Medicare Advantage |
$188.67
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$316.97
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$119.38
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$188.67
|
| Rate for Payer: Multiplan All |
$256.46
|
| Rate for Payer: New Mexico Health Connections Medicare |
$320.74
|
| Rate for Payer: OMNI Networks Commercial |
$197.27
|
| Rate for Payer: One Health Plan PPO/POS |
$253.64
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$137.84
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$119.38
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$188.67
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$267.73
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$377.34
|
| Rate for Payer: Three Rivers Provider Network All |
$211.37
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$184.90
|
| Rate for Payer: United Healthcare Managed Medicaid |
$119.38
|
| Rate for Payer: United Healthcare Medicare Advantage |
$188.67
|
| Rate for Payer: United Payors & United Providers UP&UP |
$262.09
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$188.67
|
| Rate for Payer: Zelis Auto |
$112.73
|
| Rate for Payer: Zelis Medicare |
$160.37
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$226.40
|
| Rate for Payer: Zelis Worker's Compensation |
$76.94
|
|
|
SHVING SKIN LES 1 S/N/H/F/G DIAM 0.5CM/<
|
Facility
|
IP
|
$281.82
|
|
|
Service Code
|
CPT 11305
|
| Hospital Charge Code |
8511105
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$76.94 |
| Max. Negotiated Rate |
$267.73 |
| Rate for Payer: Cash Price |
$169.09
|
| Rate for Payer: Cigna Commercial |
$239.55
|
| Rate for Payer: First Health Commercial |
$253.64
|
| Rate for Payer: First Health Workers Compensation |
$108.81
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$253.64
|
| Rate for Payer: GEHA Commercial |
$197.27
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$253.64
|
| Rate for Payer: Multiplan All |
$256.46
|
| Rate for Payer: OMNI Networks Commercial |
$197.27
|
| Rate for Payer: One Health Plan PPO/POS |
$253.64
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$267.73
|
| Rate for Payer: Three Rivers Provider Network All |
$211.37
|
| Rate for Payer: United Payors & United Providers UP&UP |
$262.09
|
| Rate for Payer: Zelis Auto |
$112.73
|
| Rate for Payer: Zelis Worker's Compensation |
$76.94
|
|
|
SHVING SKIN LES 1 S/N/H/F/G DIAM 0.5CM/<
|
Facility
|
OP
|
$281.82
|
|
|
Service Code
|
CPT 11305
|
| Hospital Charge Code |
8511105
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$76.94 |
| Max. Negotiated Rate |
$377.34 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$147.69
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$169.09
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$147.69
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$117.00
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$188.67
|
| Rate for Payer: Cash Price |
$169.09
|
| Rate for Payer: Cash Price |
$169.09
|
| Rate for Payer: Cigna Commercial |
$239.55
|
| Rate for Payer: First Health Commercial |
$253.64
|
| Rate for Payer: First Health Workers Compensation |
$108.81
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$253.64
|
| Rate for Payer: GEHA Commercial |
$225.46
|
| Rate for Payer: GEHA Medicare |
$188.67
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$253.64
|
| Rate for Payer: Humana ChoiceCare |
$207.54
|
| Rate for Payer: Humana Medicare Advantage |
$188.67
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$316.97
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$119.38
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$188.67
|
| Rate for Payer: Multiplan All |
$256.46
|
| Rate for Payer: New Mexico Health Connections Medicare |
$320.74
|
| Rate for Payer: OMNI Networks Commercial |
$197.27
|
| Rate for Payer: One Health Plan PPO/POS |
$253.64
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$137.84
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$119.38
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$188.67
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$267.73
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$377.34
|
| Rate for Payer: Three Rivers Provider Network All |
$211.37
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$184.90
|
| Rate for Payer: United Healthcare Managed Medicaid |
$119.38
|
| Rate for Payer: United Healthcare Medicare Advantage |
$188.67
|
| Rate for Payer: United Payors & United Providers UP&UP |
$262.09
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$188.67
|
| Rate for Payer: Zelis Auto |
$112.73
|
| Rate for Payer: Zelis Medicare |
$160.37
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$226.40
|
| Rate for Payer: Zelis Worker's Compensation |
$76.94
|
|
|
SHVING SKIN LES 1 S/N/H/F/G DIAM 0.5CM/<
|
Facility
|
OP
|
$302.00
|
|
|
Service Code
|
CPT 11305
|
| Hospital Charge Code |
8711305
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$82.45 |
| Max. Negotiated Rate |
$377.34 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$147.69
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$181.20
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$147.69
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$117.00
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$188.67
|
| Rate for Payer: Cash Price |
$181.20
|
| Rate for Payer: Cash Price |
$181.20
|
| Rate for Payer: Cigna Commercial |
$256.70
|
| Rate for Payer: First Health Commercial |
$271.80
|
| Rate for Payer: First Health Workers Compensation |
$116.60
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$271.80
|
| Rate for Payer: GEHA Commercial |
$241.60
|
| Rate for Payer: GEHA Medicare |
$188.67
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$271.80
|
| Rate for Payer: Humana ChoiceCare |
$207.54
|
| Rate for Payer: Humana Medicare Advantage |
$188.67
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$316.97
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$119.38
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$188.67
|
| Rate for Payer: Multiplan All |
$274.82
|
| Rate for Payer: New Mexico Health Connections Medicare |
$320.74
|
| Rate for Payer: OMNI Networks Commercial |
$211.40
|
| Rate for Payer: One Health Plan PPO/POS |
$271.80
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$137.84
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$119.38
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$188.67
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$286.90
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$377.34
|
| Rate for Payer: Three Rivers Provider Network All |
$226.50
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$184.90
|
| Rate for Payer: United Healthcare Managed Medicaid |
$119.38
|
| Rate for Payer: United Healthcare Medicare Advantage |
$188.67
|
| Rate for Payer: United Payors & United Providers UP&UP |
$280.86
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$188.67
|
| Rate for Payer: Zelis Auto |
$120.80
|
| Rate for Payer: Zelis Medicare |
$160.37
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$226.40
|
| Rate for Payer: Zelis Worker's Compensation |
$82.45
|
|
|
SHVING SKIN LES 1 S/N/H/F/G DIAM 0.5CM/<
|
Facility
|
OP
|
$302.00
|
|
|
Service Code
|
CPT 11305
|
| Hospital Charge Code |
9400005
|
|
Hospital Revenue Code
|
517
|
| Min. Negotiated Rate |
$82.45 |
| Max. Negotiated Rate |
$377.34 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$147.69
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$181.20
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$147.69
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$117.00
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$188.67
|
| Rate for Payer: Cash Price |
$181.20
|
| Rate for Payer: Cash Price |
$181.20
|
| Rate for Payer: Cigna Commercial |
$256.70
|
| Rate for Payer: First Health Commercial |
$271.80
|
| Rate for Payer: First Health Workers Compensation |
$116.60
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$271.80
|
| Rate for Payer: GEHA Commercial |
$241.60
|
| Rate for Payer: GEHA Medicare |
$188.67
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$271.80
|
| Rate for Payer: Humana ChoiceCare |
$207.54
|
| Rate for Payer: Humana Medicare Advantage |
$188.67
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$316.97
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$119.38
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$188.67
|
| Rate for Payer: Multiplan All |
$274.82
|
| Rate for Payer: New Mexico Health Connections Medicare |
$320.74
|
| Rate for Payer: OMNI Networks Commercial |
$211.40
|
| Rate for Payer: One Health Plan PPO/POS |
$271.80
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$137.84
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$119.38
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$188.67
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$286.90
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$377.34
|
| Rate for Payer: Three Rivers Provider Network All |
$226.50
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$184.90
|
| Rate for Payer: United Healthcare Managed Medicaid |
$119.38
|
| Rate for Payer: United Healthcare Medicare Advantage |
$188.67
|
| Rate for Payer: United Payors & United Providers UP&UP |
$280.86
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$188.67
|
| Rate for Payer: Zelis Auto |
$120.80
|
| Rate for Payer: Zelis Medicare |
$160.37
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$226.40
|
| Rate for Payer: Zelis Worker's Compensation |
$82.45
|
|
|
SHVING SKIN LES 1 S/N/H/F/G DIAM 0.5CM/<
|
Facility
|
OP
|
$302.00
|
|
|
Service Code
|
CPT 11305
|
| Hospital Charge Code |
8300009
|
|
Hospital Revenue Code
|
519
|
| Min. Negotiated Rate |
$82.45 |
| Max. Negotiated Rate |
$377.34 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$147.69
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$181.20
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$147.69
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$117.00
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$188.67
|
| Rate for Payer: Cash Price |
$181.20
|
| Rate for Payer: Cash Price |
$181.20
|
| Rate for Payer: Cigna Commercial |
$256.70
|
| Rate for Payer: First Health Commercial |
$271.80
|
| Rate for Payer: First Health Workers Compensation |
$116.60
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$271.80
|
| Rate for Payer: GEHA Commercial |
$241.60
|
| Rate for Payer: GEHA Medicare |
$188.67
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$271.80
|
| Rate for Payer: Humana ChoiceCare |
$207.54
|
| Rate for Payer: Humana Medicare Advantage |
$188.67
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$316.97
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$119.38
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$188.67
|
| Rate for Payer: Multiplan All |
$274.82
|
| Rate for Payer: New Mexico Health Connections Medicare |
$320.74
|
| Rate for Payer: OMNI Networks Commercial |
$211.40
|
| Rate for Payer: One Health Plan PPO/POS |
$271.80
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$137.84
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$119.38
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$188.67
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$286.90
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$377.34
|
| Rate for Payer: Three Rivers Provider Network All |
$226.50
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$184.90
|
| Rate for Payer: United Healthcare Managed Medicaid |
$119.38
|
| Rate for Payer: United Healthcare Medicare Advantage |
$188.67
|
| Rate for Payer: United Payors & United Providers UP&UP |
$280.86
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$188.67
|
| Rate for Payer: Zelis Auto |
$120.80
|
| Rate for Payer: Zelis Medicare |
$160.37
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$226.40
|
| Rate for Payer: Zelis Worker's Compensation |
$82.45
|
|
|
SHVING SKIN LES 1 S/N/H/F/G DIAM 0.5CM/<
|
Facility
|
OP
|
$302.00
|
|
|
Service Code
|
CPT 11305
|
| Hospital Charge Code |
20300135
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$82.45 |
| Max. Negotiated Rate |
$377.34 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$147.69
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$181.20
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$147.69
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$117.00
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$188.67
|
| Rate for Payer: Cash Price |
$181.20
|
| Rate for Payer: Cash Price |
$181.20
|
| Rate for Payer: Cigna Commercial |
$256.70
|
| Rate for Payer: First Health Commercial |
$271.80
|
| Rate for Payer: First Health Workers Compensation |
$116.60
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$271.80
|
| Rate for Payer: GEHA Commercial |
$241.60
|
| Rate for Payer: GEHA Medicare |
$188.67
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$271.80
|
| Rate for Payer: Humana ChoiceCare |
$207.54
|
| Rate for Payer: Humana Medicare Advantage |
$188.67
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$316.97
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$119.38
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$188.67
|
| Rate for Payer: Multiplan All |
$274.82
|
| Rate for Payer: New Mexico Health Connections Medicare |
$320.74
|
| Rate for Payer: OMNI Networks Commercial |
$211.40
|
| Rate for Payer: One Health Plan PPO/POS |
$271.80
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$137.84
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$119.38
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$188.67
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$286.90
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$377.34
|
| Rate for Payer: Three Rivers Provider Network All |
$226.50
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$184.90
|
| Rate for Payer: United Healthcare Managed Medicaid |
$119.38
|
| Rate for Payer: United Healthcare Medicare Advantage |
$188.67
|
| Rate for Payer: United Payors & United Providers UP&UP |
$280.86
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$188.67
|
| Rate for Payer: Zelis Auto |
$120.80
|
| Rate for Payer: Zelis Medicare |
$160.37
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$226.40
|
| Rate for Payer: Zelis Worker's Compensation |
$82.45
|
|
|
SHVING SKIN LES 1 S/N/H/F/G DIAM 0.5CM/<
|
Facility
|
IP
|
$446.27
|
|
|
Service Code
|
CPT 11305
|
| Hospital Charge Code |
9611305
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$121.83 |
| Max. Negotiated Rate |
$423.96 |
| Rate for Payer: Cash Price |
$267.76
|
| Rate for Payer: Cigna Commercial |
$379.33
|
| Rate for Payer: First Health Commercial |
$401.64
|
| Rate for Payer: First Health Workers Compensation |
$172.30
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$401.64
|
| Rate for Payer: GEHA Commercial |
$312.39
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$401.64
|
| Rate for Payer: Multiplan All |
$406.11
|
| Rate for Payer: OMNI Networks Commercial |
$312.39
|
| Rate for Payer: One Health Plan PPO/POS |
$401.64
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$423.96
|
| Rate for Payer: Three Rivers Provider Network All |
$334.70
|
| Rate for Payer: United Payors & United Providers UP&UP |
$415.03
|
| Rate for Payer: Zelis Auto |
$178.51
|
| Rate for Payer: Zelis Worker's Compensation |
$121.83
|
|
|
SHVING SKIN LES 1 S/N/H/F/G DIAM 0.5CM/<
|
Facility
|
IP
|
$281.82
|
|
|
Service Code
|
CPT 11305
|
| Hospital Charge Code |
7211305
|
|
Hospital Revenue Code
|
517
|
| Min. Negotiated Rate |
$76.94 |
| Max. Negotiated Rate |
$267.73 |
| Rate for Payer: Cash Price |
$169.09
|
| Rate for Payer: Cigna Commercial |
$239.55
|
| Rate for Payer: First Health Commercial |
$253.64
|
| Rate for Payer: First Health Workers Compensation |
$108.81
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$253.64
|
| Rate for Payer: GEHA Commercial |
$197.27
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$253.64
|
| Rate for Payer: Multiplan All |
$256.46
|
| Rate for Payer: OMNI Networks Commercial |
$197.27
|
| Rate for Payer: One Health Plan PPO/POS |
$253.64
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$267.73
|
| Rate for Payer: Three Rivers Provider Network All |
$211.37
|
| Rate for Payer: United Payors & United Providers UP&UP |
$262.09
|
| Rate for Payer: Zelis Auto |
$112.73
|
| Rate for Payer: Zelis Worker's Compensation |
$76.94
|
|
|
SHVING SKIN LES 1 S/N/H/F/G DIAM 0.5CM/<
|
Facility
|
OP
|
$446.27
|
|
|
Service Code
|
CPT 11305
|
| Hospital Charge Code |
9611305
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$117.00 |
| Max. Negotiated Rate |
$423.96 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$147.69
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$267.76
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$147.69
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$117.00
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$188.67
|
| Rate for Payer: Cash Price |
$267.76
|
| Rate for Payer: Cash Price |
$267.76
|
| Rate for Payer: Cigna Commercial |
$379.33
|
| Rate for Payer: First Health Commercial |
$401.64
|
| Rate for Payer: First Health Workers Compensation |
$172.30
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$401.64
|
| Rate for Payer: GEHA Commercial |
$357.02
|
| Rate for Payer: GEHA Medicare |
$188.67
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$401.64
|
| Rate for Payer: Humana ChoiceCare |
$207.54
|
| Rate for Payer: Humana Medicare Advantage |
$188.67
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$316.97
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$119.38
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$188.67
|
| Rate for Payer: Multiplan All |
$406.11
|
| Rate for Payer: New Mexico Health Connections Medicare |
$320.74
|
| Rate for Payer: OMNI Networks Commercial |
$312.39
|
| Rate for Payer: One Health Plan PPO/POS |
$401.64
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$137.84
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$119.38
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$188.67
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$423.96
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$377.34
|
| Rate for Payer: Three Rivers Provider Network All |
$334.70
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$184.90
|
| Rate for Payer: United Healthcare Managed Medicaid |
$119.38
|
| Rate for Payer: United Healthcare Medicare Advantage |
$188.67
|
| Rate for Payer: United Payors & United Providers UP&UP |
$415.03
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$188.67
|
| Rate for Payer: Zelis Auto |
$178.51
|
| Rate for Payer: Zelis Medicare |
$160.37
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$226.40
|
| Rate for Payer: Zelis Worker's Compensation |
$121.83
|
|
|
SHVING SKIN LES 1 S/N/H/F/G DIAM 0.5CM/<
|
Facility
|
OP
|
$123.00
|
|
|
Service Code
|
CPT 11305
|
| Hospital Charge Code |
6111305
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$33.58 |
| Max. Negotiated Rate |
$377.34 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$147.69
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$73.80
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$147.69
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$117.00
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$188.67
|
| Rate for Payer: Cash Price |
$73.80
|
| Rate for Payer: Cash Price |
$73.80
|
| Rate for Payer: Cigna Commercial |
$104.55
|
| Rate for Payer: First Health Commercial |
$110.70
|
| Rate for Payer: First Health Workers Compensation |
$47.49
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$110.70
|
| Rate for Payer: GEHA Commercial |
$98.40
|
| Rate for Payer: GEHA Medicare |
$188.67
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$110.70
|
| Rate for Payer: Humana ChoiceCare |
$207.54
|
| Rate for Payer: Humana Medicare Advantage |
$188.67
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$316.97
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$119.38
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$188.67
|
| Rate for Payer: Multiplan All |
$111.93
|
| Rate for Payer: New Mexico Health Connections Medicare |
$320.74
|
| Rate for Payer: OMNI Networks Commercial |
$86.10
|
| Rate for Payer: One Health Plan PPO/POS |
$110.70
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$137.84
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$119.38
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$188.67
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$116.85
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$377.34
|
| Rate for Payer: Three Rivers Provider Network All |
$92.25
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$184.90
|
| Rate for Payer: United Healthcare Managed Medicaid |
$119.38
|
| Rate for Payer: United Healthcare Medicare Advantage |
$188.67
|
| Rate for Payer: United Payors & United Providers UP&UP |
$114.39
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$188.67
|
| Rate for Payer: Zelis Auto |
$49.20
|
| Rate for Payer: Zelis Medicare |
$160.37
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$226.40
|
| Rate for Payer: Zelis Worker's Compensation |
$33.58
|
|
|
SHVING SKIN LES 1 S/N/H/F/G DIAM 0.5CM/<
|
Facility
|
IP
|
$302.00
|
|
|
Service Code
|
CPT 11305
|
| Hospital Charge Code |
8711305
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$82.45 |
| Max. Negotiated Rate |
$286.90 |
| Rate for Payer: Cash Price |
$181.20
|
| Rate for Payer: Cigna Commercial |
$256.70
|
| Rate for Payer: First Health Commercial |
$271.80
|
| Rate for Payer: First Health Workers Compensation |
$116.60
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$271.80
|
| Rate for Payer: GEHA Commercial |
$211.40
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$271.80
|
| Rate for Payer: Multiplan All |
$274.82
|
| Rate for Payer: OMNI Networks Commercial |
$211.40
|
| Rate for Payer: One Health Plan PPO/POS |
$271.80
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$286.90
|
| Rate for Payer: Three Rivers Provider Network All |
$226.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$280.86
|
| Rate for Payer: Zelis Auto |
$120.80
|
| Rate for Payer: Zelis Worker's Compensation |
$82.45
|
|
|
SHVING SKIN LES 1 S/N/H/F/G DIAM 0.5CM/<
|
Facility
|
IP
|
$123.00
|
|
|
Service Code
|
CPT 11305
|
| Hospital Charge Code |
6111305
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$33.58 |
| Max. Negotiated Rate |
$116.85 |
| Rate for Payer: Cash Price |
$73.80
|
| Rate for Payer: Cigna Commercial |
$104.55
|
| Rate for Payer: First Health Commercial |
$110.70
|
| Rate for Payer: First Health Workers Compensation |
$47.49
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$110.70
|
| Rate for Payer: GEHA Commercial |
$86.10
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$110.70
|
| Rate for Payer: Multiplan All |
$111.93
|
| Rate for Payer: OMNI Networks Commercial |
$86.10
|
| Rate for Payer: One Health Plan PPO/POS |
$110.70
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$116.85
|
| Rate for Payer: Three Rivers Provider Network All |
$92.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$114.39
|
| Rate for Payer: Zelis Auto |
$49.20
|
| Rate for Payer: Zelis Worker's Compensation |
$33.58
|
|
|
SHVING SKIN LES 1 S/N/H/F/G DIAM 0.5CM/<
|
Facility
|
IP
|
$302.00
|
|
|
Service Code
|
CPT 11305
|
| Hospital Charge Code |
9400005
|
|
Hospital Revenue Code
|
517
|
| Min. Negotiated Rate |
$82.45 |
| Max. Negotiated Rate |
$286.90 |
| Rate for Payer: Cash Price |
$181.20
|
| Rate for Payer: Cigna Commercial |
$256.70
|
| Rate for Payer: First Health Commercial |
$271.80
|
| Rate for Payer: First Health Workers Compensation |
$116.60
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$271.80
|
| Rate for Payer: GEHA Commercial |
$211.40
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$271.80
|
| Rate for Payer: Multiplan All |
$274.82
|
| Rate for Payer: OMNI Networks Commercial |
$211.40
|
| Rate for Payer: One Health Plan PPO/POS |
$271.80
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$286.90
|
| Rate for Payer: Three Rivers Provider Network All |
$226.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$280.86
|
| Rate for Payer: Zelis Auto |
$120.80
|
| Rate for Payer: Zelis Worker's Compensation |
$82.45
|
|
|
SHVING SKIN LES 1 S/N/H/F/G DIAM >2.0 CM
|
Facility
|
IP
|
$234.00
|
|
|
Service Code
|
CPT 11308
|
| Hospital Charge Code |
6111308
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$63.88 |
| Max. Negotiated Rate |
$222.30 |
| Rate for Payer: Cash Price |
$140.40
|
| Rate for Payer: Cigna Commercial |
$198.90
|
| Rate for Payer: First Health Commercial |
$210.60
|
| Rate for Payer: First Health Workers Compensation |
$90.35
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$210.60
|
| Rate for Payer: GEHA Commercial |
$163.80
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$210.60
|
| Rate for Payer: Multiplan All |
$212.94
|
| Rate for Payer: OMNI Networks Commercial |
$163.80
|
| Rate for Payer: One Health Plan PPO/POS |
$210.60
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$222.30
|
| Rate for Payer: Three Rivers Provider Network All |
$175.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$217.62
|
| Rate for Payer: Zelis Auto |
$93.60
|
| Rate for Payer: Zelis Worker's Compensation |
$63.88
|
|
|
SHVING SKIN LES 1 S/N/H/F/G DIAM >2.0 CM
|
Facility
|
OP
|
$457.00
|
|
|
Service Code
|
CPT 11308
|
| Hospital Charge Code |
9400008
|
|
Hospital Revenue Code
|
517
|
| Min. Negotiated Rate |
$70.39 |
| Max. Negotiated Rate |
$758.74 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$88.86
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$274.20
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$88.86
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$70.39
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$379.37
|
| Rate for Payer: Cash Price |
$274.20
|
| Rate for Payer: Cash Price |
$274.20
|
| Rate for Payer: Cigna Commercial |
$388.45
|
| Rate for Payer: First Health Commercial |
$411.30
|
| Rate for Payer: First Health Workers Compensation |
$176.45
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$411.30
|
| Rate for Payer: GEHA Commercial |
$365.60
|
| Rate for Payer: GEHA Medicare |
$379.37
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$411.30
|
| Rate for Payer: Humana ChoiceCare |
$417.31
|
| Rate for Payer: Humana Medicare Advantage |
$379.37
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$637.34
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$71.83
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$379.37
|
| Rate for Payer: Multiplan All |
$415.87
|
| Rate for Payer: New Mexico Health Connections Medicare |
$644.93
|
| Rate for Payer: OMNI Networks Commercial |
$319.90
|
| Rate for Payer: One Health Plan PPO/POS |
$411.30
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$82.94
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$71.83
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$379.37
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$434.15
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$758.74
|
| Rate for Payer: Three Rivers Provider Network All |
$342.75
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$371.78
|
| Rate for Payer: United Healthcare Managed Medicaid |
$71.83
|
| Rate for Payer: United Healthcare Medicare Advantage |
$379.37
|
| Rate for Payer: United Payors & United Providers UP&UP |
$425.01
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$379.37
|
| Rate for Payer: Zelis Auto |
$182.80
|
| Rate for Payer: Zelis Medicare |
$322.46
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$455.24
|
| Rate for Payer: Zelis Worker's Compensation |
$124.76
|
|
|
SHVING SKIN LES 1 S/N/H/F/G DIAM >2.0 CM
|
Facility
|
OP
|
$457.00
|
|
|
Service Code
|
CPT 11308
|
| Hospital Charge Code |
20300138
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$70.39 |
| Max. Negotiated Rate |
$758.74 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$88.86
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$274.20
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$88.86
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$70.39
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$379.37
|
| Rate for Payer: Cash Price |
$274.20
|
| Rate for Payer: Cash Price |
$274.20
|
| Rate for Payer: Cigna Commercial |
$388.45
|
| Rate for Payer: First Health Commercial |
$411.30
|
| Rate for Payer: First Health Workers Compensation |
$176.45
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$411.30
|
| Rate for Payer: GEHA Commercial |
$365.60
|
| Rate for Payer: GEHA Medicare |
$379.37
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$411.30
|
| Rate for Payer: Humana ChoiceCare |
$417.31
|
| Rate for Payer: Humana Medicare Advantage |
$379.37
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$637.34
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$71.83
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$379.37
|
| Rate for Payer: Multiplan All |
$415.87
|
| Rate for Payer: New Mexico Health Connections Medicare |
$644.93
|
| Rate for Payer: OMNI Networks Commercial |
$319.90
|
| Rate for Payer: One Health Plan PPO/POS |
$411.30
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$82.94
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$71.83
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$379.37
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$434.15
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$758.74
|
| Rate for Payer: Three Rivers Provider Network All |
$342.75
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$371.78
|
| Rate for Payer: United Healthcare Managed Medicaid |
$71.83
|
| Rate for Payer: United Healthcare Medicare Advantage |
$379.37
|
| Rate for Payer: United Payors & United Providers UP&UP |
$425.01
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$379.37
|
| Rate for Payer: Zelis Auto |
$182.80
|
| Rate for Payer: Zelis Medicare |
$322.46
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$455.24
|
| Rate for Payer: Zelis Worker's Compensation |
$124.76
|
|
|
SHVING SKIN LES 1 S/N/H/F/G DIAM >2.0 CM
|
Facility
|
IP
|
$457.00
|
|
|
Service Code
|
CPT 11308
|
| Hospital Charge Code |
20300138
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$124.76 |
| Max. Negotiated Rate |
$434.15 |
| Rate for Payer: Cash Price |
$274.20
|
| Rate for Payer: Cigna Commercial |
$388.45
|
| Rate for Payer: First Health Commercial |
$411.30
|
| Rate for Payer: First Health Workers Compensation |
$176.45
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$411.30
|
| Rate for Payer: GEHA Commercial |
$319.90
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$411.30
|
| Rate for Payer: Multiplan All |
$415.87
|
| Rate for Payer: OMNI Networks Commercial |
$319.90
|
| Rate for Payer: One Health Plan PPO/POS |
$411.30
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$434.15
|
| Rate for Payer: Three Rivers Provider Network All |
$342.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$425.01
|
| Rate for Payer: Zelis Auto |
$182.80
|
| Rate for Payer: Zelis Worker's Compensation |
$124.76
|
|
|
SHVING SKIN LES 1 S/N/H/F/G DIAM >2.0 CM
|
Facility
|
OP
|
$395.25
|
|
|
Service Code
|
CPT 11308
|
| Hospital Charge Code |
7211308
|
|
Hospital Revenue Code
|
517
|
| Min. Negotiated Rate |
$70.39 |
| Max. Negotiated Rate |
$758.74 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$88.86
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$237.15
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$88.86
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$70.39
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$379.37
|
| Rate for Payer: Cash Price |
$237.15
|
| Rate for Payer: Cash Price |
$237.15
|
| Rate for Payer: Cigna Commercial |
$335.96
|
| Rate for Payer: First Health Commercial |
$355.73
|
| Rate for Payer: First Health Workers Compensation |
$152.61
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$355.73
|
| Rate for Payer: GEHA Commercial |
$316.20
|
| Rate for Payer: GEHA Medicare |
$379.37
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$355.73
|
| Rate for Payer: Humana ChoiceCare |
$417.31
|
| Rate for Payer: Humana Medicare Advantage |
$379.37
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$637.34
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$71.83
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$379.37
|
| Rate for Payer: Multiplan All |
$359.68
|
| Rate for Payer: New Mexico Health Connections Medicare |
$644.93
|
| Rate for Payer: OMNI Networks Commercial |
$276.68
|
| Rate for Payer: One Health Plan PPO/POS |
$355.73
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$82.94
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$71.83
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$379.37
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$375.49
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$758.74
|
| Rate for Payer: Three Rivers Provider Network All |
$296.44
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$371.78
|
| Rate for Payer: United Healthcare Managed Medicaid |
$71.83
|
| Rate for Payer: United Healthcare Medicare Advantage |
$379.37
|
| Rate for Payer: United Payors & United Providers UP&UP |
$367.58
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$379.37
|
| Rate for Payer: Zelis Auto |
$158.10
|
| Rate for Payer: Zelis Medicare |
$322.46
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$455.24
|
| Rate for Payer: Zelis Worker's Compensation |
$107.90
|
|
|
SHVING SKIN LES 1 S/N/H/F/G DIAM >2.0 CM
|
Facility
|
OP
|
$234.00
|
|
|
Service Code
|
CPT 11308
|
| Hospital Charge Code |
6111308
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$63.88 |
| Max. Negotiated Rate |
$758.74 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$88.86
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$140.40
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$88.86
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$70.39
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$379.37
|
| Rate for Payer: Cash Price |
$140.40
|
| Rate for Payer: Cash Price |
$140.40
|
| Rate for Payer: Cigna Commercial |
$198.90
|
| Rate for Payer: First Health Commercial |
$210.60
|
| Rate for Payer: First Health Workers Compensation |
$90.35
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$210.60
|
| Rate for Payer: GEHA Commercial |
$187.20
|
| Rate for Payer: GEHA Medicare |
$379.37
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$210.60
|
| Rate for Payer: Humana ChoiceCare |
$417.31
|
| Rate for Payer: Humana Medicare Advantage |
$379.37
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$637.34
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$71.83
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$379.37
|
| Rate for Payer: Multiplan All |
$212.94
|
| Rate for Payer: New Mexico Health Connections Medicare |
$644.93
|
| Rate for Payer: OMNI Networks Commercial |
$163.80
|
| Rate for Payer: One Health Plan PPO/POS |
$210.60
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$82.94
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$71.83
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$379.37
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$222.30
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$758.74
|
| Rate for Payer: Three Rivers Provider Network All |
$175.50
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$371.78
|
| Rate for Payer: United Healthcare Managed Medicaid |
$71.83
|
| Rate for Payer: United Healthcare Medicare Advantage |
$379.37
|
| Rate for Payer: United Payors & United Providers UP&UP |
$217.62
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$379.37
|
| Rate for Payer: Zelis Auto |
$93.60
|
| Rate for Payer: Zelis Medicare |
$322.46
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$455.24
|
| Rate for Payer: Zelis Worker's Compensation |
$63.88
|
|
